- Independent Living Systems (Miami, FL)
- …(EHR) systems and healthcare data analytics platforms. Knowledge of healthcare quality improvement frameworks and member safety standards. Experience working ... Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable...At least 4 years of experience as a Business Analyst within the healthcare industry. Proficient knowledge… more
- Cognizant (Tallahassee, FL)
- About the role As a ** Quality Analyst with Healthcare - Claims & Membership experience** . You will make an impact by designing and executing end-to-end ... test strategies that ensure the quality and reliability of healthcare claims and membership applications. You will be a valued member of the Quality … more
- Molina Healthcare (St. Petersburg, FL)
- …and work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant… more
- Molina Healthcare (Jacksonville, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... business requirements. Lead and participate in audit initiatives, develop quality control framework, and collaborate cross-functionally to drive continuous… more
- Molina Healthcare (FL)
- …Microsoft Azure, AWS or Hadoop. * 3-5 Years of experience with predictive modeling in healthcare quality data. * 5+ Years of experience in Analysis related to ... **Job Summary** The Lead Analyst , Quality Analytics and Performance Improvement...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates * Assists and… more
- Molina Healthcare (Tampa, FL)
- …Microsoft Azure, AWS or Hadoop. + 1-3 Years of experience with predictive modeling in healthcare quality data. + 1-3 Years of experience in Analysis related to ... **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement...Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS measure deep dive to support… more
- Evolent (Tallahassee, FL)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Elevance Health (FL)
- **Senior Healthcare Economics Analyst ** **Location:** Chicago, IL; Atlanta, GA; Indianapolis, IN; Richmond, VA (preferred). This role requires associates to be ... position is not eligible for current or future visa sponsorship._ The **Senior Healthcare Economics Analyst ** (Advanced Analytics Analyst Senior) creates… more
- Molina Healthcare (FL)
- …Knowledge of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...related to cost, utilization and revenue for multiple Molina Healthcare products. Designs and develops reports to monitor health… more
- Molina Healthcare (Jacksonville, FL)
- …proficiency in SQL for large dataset analysis and transformation, specifically in processing healthcare claims data and supporting managed care reporting needs + ... solutions. * Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. *… more
- Elevance Health (Miami, FL)
- **Performance Quality Analyst II** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... accommodation is granted as required by law. The **Performance Quality Analyst II** is responsible for driving...claims and/or customer contact automated environment (preferably in healthcare or insurance sector), including a minimum of 1… more
- CVS Health (FL)
- …we do it all with heart, each and every day. **Position Summary** A Quality Assurance Senior Analyst reviews business requirements and translates them into ... both documentation and hands-on experience. **Preferred Qualifications** + Background in healthcare or claims processing experience. + Experience with Aetna… more
- Molina Healthcare (Tampa, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... improvement processes to ensure systems are working more efficiently and improve quality . + Assists in planning and coordination of application upgrades and… more
- LogixHealth (Dania, FL)
- Location: On-Site in Dania, FL $500 Signing Bonus This Role: As a Reimbursement Analyst at LogixHealth, you will work with the department management teams to provide ... cutting edge solutions that will directly improve the healthcare industry. You'll contribute to our fast-paced, collaborative environment and bring your expertise to… more
- Molina Healthcare (Tampa, FL)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... accuracy in a timely manner to meet department standards of turnaround time and quality . + Audit loaded provider records for quality and financial accuracy and… more
- University of Miami (Miami, FL)
- …Health System, "UHealth", IT Department has an exciting opportunity for a Full-time Epic Sr. Analyst - Quality and Population Health. The Epic Sr. Analyst - ... and procedures and safeguards University assets. Department Specific Functions: As an Epic Analyst - Quality and Population Health, you will: + Build and… more
- Molina Healthcare (Jacksonville, FL)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... management and credentialing. **KNOWLEDGE/SKILLS/ABILITIES** + Generates data to support continuous quality of provider data and developing SOPs and/or BRDs. +… more
- Prime Therapeutics (Tallahassee, FL)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... passion and drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with… more
- Molina Healthcare (Miami, FL)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... and credentialing. **KNOWLEDGE/SKILLS/ABILITIES** + Audits loaded provider records for quality and financial accuracy and provides documented feedback. + Assists… more
- Molina Healthcare (FL)
- **Job Description** **Job Summary** Supports ongoing Claims and Enrollment operations in the management of smaller scale, less complex vendor activities. Provides ... Reviews and analyzes gaps to improve organizational processes, and works to improve quality , productivity, and efficiency in partnership with the team and the vendor… more
